{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MISTY OSBORNE","gend":1,"add":"1579 GALLIMORE ST","city":"CHRISTIANSBURG","state":"VA","zip":"24073-9998","dob":"1981-05-13","age":"","mstatus":"","insh":"11009471","cliId":"","pno":5403925494,"cno":"","email":"","ename":"","eno":"","pphy":"SNOW, JULIANNA","ppno":5407312000,"pcpadd":"2900 LAMB CIRCLE","pcpcity":"CHRISTIANSBURG","pcpstate":"VA","pcpzip":240736344,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE CHRISTIANBURG","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1579 GALLIMORE ST","madd2":"","madd3":"","mcity":"CHRISTIANSBURG","mstate":"VA","mzip":"24073-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","64764017530","DEXILANT ","60MG DR","30.00","Select","Select",""],["","42858000401","OXYCODONE ","20MG","120.00","Select","Select",""],["","42571012290","LEVOCETIRIZI ","5MG","30.00","Select","Select",""],["","60432026415","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","72618300002","NURTEC ","75MG ODT","8.00","Select","Select",""],["","59746012206","MECLIZINE ","12.5MG","30.00","Select","Select",""],["","64764024060","AMITIZA ","24MCG","180.00","Select","Select",""],["","43547039950","CYCLOBENZAPR ","5MG","90.00","Select","Select",""],["","65862086001","FAMOTIDINE ","40MG","30.00","Select","Select",""],["","51224002218","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","68180012202","CEPHALEXIN ","500MG","28.00","Select","Select",""],["","00172392660","DIAZEPAM ","5MG","2.00","Select","Select",""],["","60505057804","AZELASTINE ","0.05%","6.00","Select","Select",""],["","61442010310","DICLOFENAC ","75MG DR","60.00","Select","Select",""],["","69547035302","NARCAN ","","2.00","Select","Select",""],["","64380080438","RANITIDINE ","300MG","30.00","Select","Select",""],["","55111012705","CIPROFLOXACN ","500MG","10.00","Select","Select",""],["","76385012450","METHOCARBAM ","750MG","60.00","Select","Select",""],["","65862039110","ONDANSETRON ","8MG ODT","10.00","Select","Select",""],["","42858011830","LIDOCAINE ","5%","60.00","Select","Select",""],["","33332032001","AFLURIA ","2020-21","0.50","Select","Select",""],["","70954006110","PREDNISONE ","50MG","5.00","Select","Select",""],["","10702000310","PROMETHAZINE ","25MG","12.00","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}